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This publication is available at https://www.gov.uk/government/publications/covid-19-guidance-on-supporting-children-and-young-peoples-mental-health-and-wellbeing/guidance-for-parents-and-carers-on-supporting-children-and-young-peoples-mental-health-and-wellbeing-during-the-coronavirus-covid-19-outbreak

What you need to know

The coronavirus (COVID-19) pandemic is going to affect daily life, as the government and the NHS take necessary steps to manage the pandemic, reduce transmission and treat those who need medical attention.

Regardless of their age, this may be a difficult time for children and young people. Some may react immediately, while others may show signs of difficulty later on.

How a child or young person reacts can vary according to their age, how they understand information and communicate, their previous experiences, and how they typically cope with stress. Adverse reactions may include thinking about their health or that of family and friends, fear, avoidance, problems sleeping or physical symptoms such as stomach ache.

During this time, it’s important that you support and take care of your family’s mental health – there are lots of things you can do, and additional support is available if you need it.

Background

This advice is to help adults with caring responsibilities look after the mental health and wellbeing of children and young people, including those with additional needs and disabilities, during the coronavirus (COVID-19) pandemic.

Looking after your own mental health

As well as thinking about the children or young people in your care, it is important to take care of your own mental health and wellbeing. Children and young people react, in part, to what they see from the adults around them. When parents and carers deal with a situation calmly and confidently, they can provide the best support for their children and young people. Parents and carers can be more supportive to others around them, especially children, when they are better prepared.

Helping children and young people cope with stress

There are some key points you can consider about how to support your child or young person, including:

Listen and acknowledge: Children and young people may respond to stress in different ways. Signs may be emotional (for example, they may be upset, distressed, anxious, angry or agitated), behavioural (for example, they may become more clingy or more withdrawn, or they may wet the bed), or physical (for example, they may experience stomach aches).

Look out for any changes in their behaviour. Children and young people may feel less anxious if they are able to express and communicate their feelings in a safe and supportive environment. Children and young people who communicate differently to their peers may rely on you to interpret their feelings. Listen to them, acknowledge their concern and give them extra love and attention if they need it.

MindEd is a free online educational resource on children and young people’s mental health for all adults, which can support parents and carers through these exceptional circumstances.

Provide clear information about the situation: Children and young people want to feel assured that their parents and carers can keep them safe. One of the best ways to achieve this is by talking openly about what is happening and providing honest answers to any questions they have. Explain what is being done to keep them and their loved ones safe, including any actions they can take to help, such as washing their hands more often than usual. Use words and explanations that they can understand. There are resources available to help you do this, including the Children’s Commissioner’s Children’s Guide to Coronavirus, or the Inter-Agency Standing Committee (IASC) have produced a storybook developed by and for children around the world affected by coronavirus (COVID-19).

Make sure you use reliable sources of information such as GOV.UK or the NHS website – there is a lot of misleading information from other sources that can create stress for you and your family. It will not always be possible to provide answers to all the questions that children and young people may ask, or to address all their concerns, so focus on listening and acknowledging their feelings to help them feel supported.

Be aware of your own reactions: Remember that children and young people often take their emotional cues from the important adults in their lives, so how you respond to the situation is very important. It is important to manage your own emotions and remain calm, listen to and acknowledge children and young people’s concerns, speak kindly to them, and answer any questions they have honestly. For further information on how to look after your own mental wellbeing during the pandemic, see the guidance on how to look after your own mental health and wellbeing or visit Every Mind Matters.

Connect regularly: If it is necessary for you and your children to be in different locations to normal (for example, due to staying at home in different locations or hospitalisation) make sure you still have regular and frequent contact via the phone or video calls with them. Try to help your child understand what arrangements are being made for them and why in simple terms. Support safe ways for children and young people to maintain social interaction with their friends, for example via phone or video calls.

Create a new routine: Life is changing for all of us for a while. Routine gives children and young people an increased feeling of safety in the context of uncertainty, so think about how to develop a new routine, especially if they are not at school:

make a plan for the day or week that includes time for learning, playing and relaxing

encourage maintaining a balance between being on and offline and discover new ideas for activities to do from home. The Children’s Commissioner guide signposts to some ideas to help fight boredom

children and young people ideally need to be active for 60 minutes a day, which can be more difficult when spending longer periods of time indoors. Plan time outside if you can do so safely or see Change4Life for ideas for indoor games and activities

don’t forget that sleep is important for mental and physical health, so try to keep to existing bedtime routines

it may be tempting to give children and young people treats such as sweets or chocolate but this is not good for their health, especially as they may not be as physically active as normal. See Change4Life for ideas for healthy treats

Limit exposure to media and talk more about what they have seen and heard: Like adults, children and young people may become more distressed if they see repeated coverage about the coronavirus (COVID-19) pandemic in the media. A complete news blackout is also rarely helpful as they are likely to find out from other sources, such as online or through friends. Try to avoid turning the television off or closing web pages when children or young people come into the room. This can pique their interest to find out what is happening and their imagination can take over. Instead, consider limiting the amount of exposure you and your family have to media coverage.

Young people will also hear things from friends and get information from social media. Talk to them about what is happening and ask them what they have heard. Try to answer their questions honestly and reassure them appropriately.

How children and young people of different ages may react

All children and young people are different, but there are some common ways in which different age groups may react to a situation like the coronavirus (COVID-19) pandemic. Understanding these may help you to support your family. The common reactions to distress will fade over time for most children and young people, though could return if they see or hear reminders of what happened.

For infants to 2-year olds

Infants may become more easily distressed. They may cry more than usual or want to be held and cuddled more.

For 3 to 6-year olds

Preschool and nursery children may return to behaviours they have outgrown. For example, toileting accidents, bed-wetting, or being frightened about being separated from their parents or carers. They may also have tantrums or difficulty sleeping.

For 7 to 10-year olds

Older children may feel sad, angry, or afraid. Peers may share false information but parents or carers can correct the misinformation. Older children may focus on details of the situation and want to talk about it all the time, or not want to talk about it at all. They may have trouble concentrating.

For preteens and teenagers

Some preteens and teenagers respond to worrying situations by acting out. This could include reckless driving, and alcohol or drug use. Others may become afraid to leave the home. They may cut back on how much time they connect with their friends. They can feel overwhelmed by their intense emotions and feel unable to talk about them. Their emotions may lead to increased arguing and even fighting with siblings, parents, carers or other adults. They may have concerns about how the school closures and exam cancellations will affect them.

Children and young people who are accessing mental health services

Children and young people with an existing mental health problem may find the current uncertainty around the coronavirus (COVID-19) pandemic particularly difficult. Their increased stress may lead to a change in their behaviours and their mental health needs. If you are concerned about how to access support if they need to stay at home, you may want to think about the following actions:

Speak to your child or young person’s mental health team

Contact your child or young person’s mental health team to discuss any concerns and check how care will continue to be accessed while you are at home. Update any safety and care plans as agreed.

Identify how the support your child or young person normally receives can be maintained

Ask about having appointments by phone, text or online, and how their health professional can offer extra support if your child or young person needs it.

If you usually have support in your home, check with your local authority or care provider what alternative arrangements are in place. Make sure it is clear if support is still needed for your child or young person.

If your child or young person has been admitted to an inpatient mental health unit, talk to the staff about their policies on access to mobile phones and think about how you can stay in contact, particularly if you have to stay at home. Ask the unit if you could participate in a virtual ward round to keep in touch with your child or young person’s mental health team. If you need to stay at home this will also impact on whether your child or young person can come home on leave, so talk to your child or young person about what might happen so they are fully informed.

If your child or young person becomes affected by coronavirus (COVID-19) they will need to be cared for appropriately, so talk to the unit about what plans are in place should this happen and how best to communicate these to your child or young person.

Plan how you will access medication

You might be able to order repeat prescriptions by phone. Or you may be able to do this online using an app or website if your doctor’s surgery offers this.

Continue to order repeat prescriptions in your usual timeframe. There is no need to order for a longer duration or larger quantities.

Your GP might convert your child or young person’s repeat prescription to one that is supplied under the repeat dispensing arrangements. This means you can go back to the pharmacy for a certain number of repeats without having to get a repeat prescription from the practice.

You might also want to make arrangements for your child or young person if you become unwell, for example, making sure a partner, friend, family member or neighbour is aware of important information including their care plan, medications and emergency numbers.

Eating disorders

Children and young people with an eating disorder may find aspects of the current situation particularly challenging, for example, reduced availability of specific foods, exercise limits, social isolation and significant changes to routine.

If your child or young person has an eating disorder, you can seek support and advice from your local community eating disorder team. Most community eating disorder teams support direct access that is not reliant on a referral from your GP.

For children and young people with avoidant restrictive food intake disorder (ARFID), take care about issues that arise if there is:

reduced availability of specific foods. This may mean your child or young person who is on a limited diet cannot get the foods they eat. Many will go without rather than have something else but with risk of weight loss or further nutritional deficiency

significant changes to your child or young person’s routine – for those with ARFID this can be extremely distressing and challenging to manage. Seek advice on how you can reduce the distress and risk of further reduction of their food intake

general heightened anxiety – monitor existing anxiety and obsessive-compulsive behaviours that are associated with distress and how this is interfering with eating

A good way to help them could be by supporting their decisions, representing choices visually through written words, pictures, symbol systems or objects if helpful, supporting them to express their emotions and letting them know they are not alone. While listening, take their feelings seriously and don’t judge their emotions. They may feel anxious about big changes, such as the possibility of having to stay at home for a long period. Where possible, it can be helpful to explain any upcoming changes to routine and circumstances before they happen and help them to plan and come up with solutions, such as finding a hobby or doing exercises to relax and cope with anxiety.

For useful tips for talking about feelings, see Skills for Care advice. For further guidance on coronavirus (COVID19) for those with learning disabilities please see the Mencap website (includes easy read materials). BILD (the Learning Disability Professional Senate) have also published a collection of resources that may be useful to support families or carers of people with learning disabilities during the coronavirus restrictions.

If your child or young person has a specific health condition that requires them to leave the house to maintain their health – including if that involves travel beyond your local area – then you can if safe to do so. For example, if your child or young person requires specific exercise in an open space 2 or 3 times each day. This should ideally be in line with a care plan agreed with a medical professional. Even in such cases, in order to reduce the spread of infection and protect those exercising, travel outside of the home should be limited, as close to your local area as possible, and you should remain at least 2 metres apart from anyone who is not a member of your household or a carer at all times.

Autistic children and young people

Autistic children and young people may struggle to identify any physical symptoms of coronavirus (COVID-19), as well as having difficulty talking about the emotions the situation will create. Keep an eye out for changes in behaviour which may help you to identify their emotional state, as well as physical symptoms.

There is going to be disruption for all of us during the pandemic, for example, it will not be possible to follow normal routines, or visit older family members. If your child or young person becomes ill, they may struggle to manage the physical experience. You can help to manage these changes using any strategies that you know work for your family, or see sources of further advice and support at the bottom of this section.

It is important to be honest when communicating with your child or young person about the changing situation, measures they can take to stay safe, and the symptoms of the virus. Try to avoid giving definitive statements about the future – this is a rapidly developing situation and your child or young person may be more distressed if things change when they were told they would not. Keep up to date with official information about coronavirus (COVID-19).

If your child or young person has a specific health condition that requires them to leave the house to maintain their health – including if that involves travel beyond your local area – then you can if safe to do so. For example, if your child or young person requires specific exercise in an open space 2 or 3 times each day. This should ideally be in line with a care plan agreed with a medical professional. Even in such cases, in order to reduce the spread of infection and protect those exercising, travel outside of the home should be limited, as close to your local area as possible, and you should remain at least 2 metres apart from anyone who is not a member of your household or a carer at all times.

Children or young people with physical health issues

Children or young people with long term physical health issues, such as those who need continuous use of a breathing machine or are confined to a wheelchair or bed, may have stronger reactions to the coronavirus (COVID-19) pandemic. They might have more intense distress, worry or anger than children without these issues because they have less control over day-to-day wellbeing than other people. Support them by listening to their concerns, providing open and honest explanations about the situation, and giving them information about what is being done to protect them.

You may also be concerned about how you will continue their care if you have to stay at home, or you may be worried about infecting them. If you usually have support in your home, check with your local authority or care provider what alternative arrangements are in place. Make sure it is clear if support is still needed for your child or young person.

Children and young people who care for others

Some children and young people may also have existing caring responsibilities for adults or siblings. They may be anxious about what will happen if the person they care for becomes unwell, or what will happen if they themselves become unwell and are unable to support the person they care for. Even if they don’t currently act as a carer, it is possible that they may become one if they are in a household with one adult.

Planning with your child or young person what will happen if you or another member of the family they care for or may need to care for becomes unwell, including contact details for others who can step in and support them, will help to reduce anxiety.

Bullying

The coronavirus (COVID-19) pandemic may lead to some individuals experiencing bullying, discrimination or harassment, for example, due to their ethnicity or nationality, or perceived illness. It is important to check that your children and young people are not experiencing bullying or bullying others.

Remind your children and young people that everyone deserves to be safe wherever they are – including online and at home. Bullying is always wrong, and we should each do our part to spread kindness and support each other. If they have been called names or bullied, they should feel comfortable telling an adult whom they trust.

Experiencing grief or bereavement

Whenever it happens, experiencing the loss of a friend or loved one can be an extremely difficult and challenging time. Children and young people may not be able to say goodbye in the way they would have wanted and it may be harder to connect with their usual support networks.

Grief affects children and young people in different ways depending on their age, their level of understanding, and the changes the death means for their daily life. They often feel waves of powerful emotions such as sadness, guilt, shock and anger, which they may struggle to express. It is very common for their behaviour to change and for them to worry a lot about other people.

It can be challenging to support a child when you are grieving yourself. Listening carefully, answering questions honestly in an age-appropriate way, continuing routines where possible, and providing lots of love and support will help. The NHS has advice about grief and the support available, and the Childhood Bereavement Network has information and links to national and local support organisations.

Where to get further support

If you are worried about your or your child or young person’s symptoms, see the NHS website. If you have no internet access, you should call NHS 111.

If you are worried about your child or young person’s mental health, seek help from a professional. You may have services attached to your child or young person’s school or college who can help. You could also contact your GP, or look up information on children and young people’s mental health services on your local CCG website or on the NHS website.

In a medical emergency call 999. This phone line should be used when someone is seriously ill or injured and their life is at risk. A mental health emergency should be taken as seriously as a physical health emergency and is a situation where your child or young person requires immediate professional care. For more advice on where to get support for a mental health crisis please see this NHS page.

If you do not feel safe at home there is help and support available to you and your family. The household isolation instruction as a result of coronavirus does not apply if you need to leave your home to escape domestic abuse.

Abuse is unacceptable in any situation, no matter what stresses you or others are under. If you or others are in immediate danger, call 999 and ask for the police – the police will continue to respond to emergency calls.

For support as a parent or carer

Young Minds for Parents and Carers

Young Minds provides advice about mental health and behaviour problems in children and young people up to the age of 25. You can call the Parents’ and Carers’ Helpline on 0808 802 5544. Please be aware Young Minds do not provide any direct psychological services and cannot make referrals to the NHS or Children and Young People’s Mental Health Services (CYPMHS).

Helplines and websites for your child and or young person

If your child or young person would like to speak to someone anonymously, they could try calling a helpline or visiting websites such as ChildLine and The Mix.

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